HomeMy WebLinkAboutCFR-01.03.2017-NicholsonTexas Ethics Commission RO. Box 12070 Austin. Texas 78711.2070 (5121463-5800 (TDD 1-800-735-99891
APPOINTMENT OF A CAMPAIGN TREASURER FORM CTA
BY A CANDIDATE PG
See CTA Instruction Guide for detailed instructions.
1 Total pages filed:
2 CANDIDATE
M5 RS)MR FIRST MI
OFFICE USE ONLY
NAME
v, `�� j� Q
L � V
Acct. 71
NICKNAME . . . . . . . LAST . . . . . . . . . . . . . . . SUFFIX .
Dale Received
f • C (^ 0 1 r' rr, �.,
`�
3 CANDIDATE
ADDRESS /PO BOX; APT/SU ITE 9; CITY; STATE; ZIP CODE
MAILING
ADDRESS
ll��
4 CANDIDATE
AREA CODE PHONE NUMBER EXTENSION
Date Hand -delivered or Postmarked
PHONE
Dale Processed
5 OFFICE
Date Imaged
HELD
.—
(if any)
6 OFFICE
SOUGHT
(if known}
�/�
�INI V� RjO r D ilj� U� Li
7 CAMPAIGN
MS IR MR FIRST MI NICKNAME LAST SUFFIX
TREASURER
NAME
I.
�G javk i'Vt i to
8 CAMPAIGN
STREET ADDRESS {NO PO BOX PLEASE): APT I SUITE #; CITY; STATE; ZIP CODE
TREASURER
STREET
ADDRESS
(residence or business)
9 CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
10 CANDIDATE
SIGNATURE
I am aware of the Nepotism Law, Chapter 573 of the Texas Government Code.
1 am aware of my responsibility to file timely reports as required by title 15 of
the Election Code.
I am aware of the restrictions in title 15 of the Election Code on contributions
from corporations and labor organizations.
Signature of Candidate Date Signed
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www.ethics.state.tx.us Revised 07114/2010